Page 26 - Claims Binders Mandates and Guidelines

3.7.1 3.7.2 3.7.3 3.7.4 3.7.5 3.7.6
3.8 Check to
3.8.1 3.8.2 3.8.3
a claims checklist
action sheet/file note
a printout of the claimant’s policy document details and schedule (the proposal, if required)
one hard copy of the claim printout
any other documentation and copies of letters
a note of any other relevant information gleaned from the conversation with the claimant (noted on the action sheet).
see whether the following have been requested and/or received:
any outstanding documentation
assessor’s report (if required)
validation of the driver’s license (if required).
3.9 In the case of positive criminal investigation or red flag indicators, an investigator needs to be appointed.
3.9.1 If a criminal case is being investigated, relating to any of the policy exclusions (for example, drunken driving; the driver has no license), the outcome of the case must be obtained before any authorisation can be given.
3.9.2 Diarise the file to follow up on the reply from the SAPS.
NOTE: The case number prefix CR/MR and CAS/MAS are current case number prefixes that must be investigated. Should any other prefixes become known to a claim’s person, this information must be forwarded to Hollard Insure. Sometimes there will be both an AR/OR number and a CR/MR or CAS/MAS number. Always ask if a criminal docket has been opened.
4. WINDSCREEN/GLASS DAMAGE
4.1 When you are notified of a potential windscreen claim:
4.1.1 instruct the claimant to contact the relevant glazier (if they have not already done so) or a Hollard Insure approved glass supplier.
4.1.2 inform the claimant that he will need to have his ID book, driver’s license, and policy number ready (if possible) when the glazier repairs or replaces the glass.
4.2 If the windscreen has to be replaced, inform the claimant of the excess payable by him.
NOTE: Inform the claimant that if the damage can be repaired instead of the windscreen being replaced, there will be no excess applicable.
4.3 The glazier will contact the binder holder and has to provide the following:
4.3.1 policy/claim number (wherever possible)
4.3.2 registration number of vehicle
4.3.3 make/model of vehicle.
4.4 Place the following onto the file:
4.4.1 4.4.2
a claims checklist action sheet
Motor Claims Procedures
3.4 Should there be any documents outstanding, contact the claimant telephonically or by email and request these from him.
3.5 Check that the license is in order.
3.6 Contact the claimant and inform him/her of the claim number, which is to be used in all correspondence, as well as the name of the claims handler who will be handling the claim.
3.7 Place the following on the file:
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Claims Binder Holders Mandates and Guidelines – V6: 2022